Department of Community Prevention and Care Services, National Agency for the Control of AIDS, Ziguinchor Street, off IBB Way, Wuse Zone 4, Abuja, Nigeria.
Center for Translation and Implementation Research, University of Nigeria Nsukka, Enugu, Nigeria.
BMC Prim Care. 2023 Oct 17;24(1):209. doi: 10.1186/s12875-023-02157-8.
Hepatitis B virus (HBV) screening is an important component of antenatal care for pregnant women in Nigeria. However, the screening rates remain low, particularly at primary healthcare centers (PHCs). The objective of this study was to identify the barriers affecting antenatal HBV screening in PHCs in Nigeria from the perspective of health workers.
We conducted a survey among 30 health workers from 30 PHCs (one per PHC) across three states (Akwa Ibom, Anambra, and Kaduna) in Nigeria. An open-ended questionnaire was used to obtain written responses on the perceived barriers limiting antenatal HBV screening in PHCs and their recommended solutions to the identified barriers. The data were analyzed using an inductive thematic approach.
The perceived barriers exist at patient, provider and health system levels. They included: lack of test kits, unaffordability of HBV test, shortage of trained personnel, poor awareness among pregnant women, knowledge of HBV among health workers, high cost of antiviral treatment, and unavailability of HBV vaccine. The recommended solutions to the identified barriers were: making test kits and vaccines available and free, creating awareness about HBV, and capacity-building interventions for health workers.
HBV screening of pregnant women attending PHCs in Nigeria appears to be affected by multilevel barriers. As the country continues to work towards eliminating HBV, these highlighted barriers at the patient, provider and health system levels must be addressed through effective and sustainable interventions.
乙型肝炎病毒(HBV)筛查是尼日利亚孕妇产前护理的重要组成部分。然而,筛查率仍然很低,特别是在初级保健中心(PHC)。本研究的目的是从卫生工作者的角度确定影响尼日利亚 PHC 产前 HBV 筛查的障碍。
我们在尼日利亚三个州(阿克瓦伊博姆州、阿南布拉州和卡杜纳州)的 30 个 PHC 中对 30 名卫生工作者进行了调查(每个 PHC 一名)。使用开放式问卷,就 PHC 中限制产前 HBV 筛查的感知障碍及其对已确定障碍的建议解决方案,获得书面答复。使用归纳主题方法分析数据。
感知障碍存在于患者、提供者和卫生系统层面。它们包括:缺乏检测试剂盒、HBV 检测费用不可承受、缺乏训练有素的人员、孕妇意识淡薄、卫生工作者对 HBV 的了解、抗病毒治疗费用高以及 HBV 疫苗供应不足。针对已确定障碍的建议解决方案包括:提供和免费提供检测试剂盒和疫苗、提高对 HBV 的认识以及对卫生工作者进行能力建设干预。
在尼日利亚,参加 PHC 的孕妇的 HBV 筛查似乎受到多层次障碍的影响。随着该国继续努力消除 HBV,必须通过有效和可持续的干预措施来解决患者、提供者和卫生系统层面上突出的障碍。